Juvenile Idiopathic Arthritis

Question 1

what is it?

Answer 1

group of systemic inflammatory disorders that affect < 16 year olds

Question 2

aetiology?

Answer 2

auto-immune

Question 3

clinical sub-types?

Answer 3

• Pauarticular- <4 joints involved
• Polyarticular- >4 joints involved
• Systemic

Question 4

Criteria for diagnosis?

Answer 4

• < 16 years old
• symptoms for > 6 weeks
• presence of arthritis symptoms:

swelling

OR 2 of the following:

• painful / limited joint motion
• tenderness
• warmth

Question 5

Management?

Answer 5

1st line - NSAIDs / joint steroid injections

2nd line - methotrexate

3rd line: if failed DMARD treatment- Anti TNFa / IL1/6 blockers

other- physio / surgery

Question 6

what kind of surgery could be done?

Answer 6

synovectomy

• removal of synovium as this is usually the part of the joint most affected by chronic inflammation

Question 7

features of systemic JIA?

Answer 7

• Systemically unwell
  
  • Intermittent fever > 2 weeks
  • Pink erythematous rash
  • Generalised lymphadenopathy
  • Serositis
  • Hepatomegaly / splenomegaly
  • High inflammatory markers